1. In general, there is no set answer. It’s not that this kind of surgery must be done at 8 months of age and not at 1 year of age, or that it must be done at 2 years of age and absolutely not at 6 months of age. But there are some general principles. Most malformations require surgery within 2-3 years of age. In the past, due to the lack of understanding of the disease and surgical experience, it was thought that “we should wait until we are older, about 12 years old, and operate when we are mature”, this concept should be abandoned. This is mainly due to the fact that children who are too young can not tolerate prolonged surgery, and the risk of anesthesia is relatively high. This is mainly because children too young to tolerate prolonged surgery are at greater risk of anesthesia, and it is better to wait until they are older for slightly more complex surgery. Another reason is that children who are too young have unclear anatomy or are too small to perform effective surgical procedures. There are some exceptions, such as superfluous fingers with very small tips, which can be removed early by clamping or tying. Overseas, some people in the neonatal period surgery to separate the juxtaposed finger, it is said that the effect is okay, but it has not been universally recognized. Sometimes, if the deformity is allowed to develop, secondary bone and joint development problems may occur, such as borderline syndactyly (thumb and pointer finger, or ring finger and little finger), central polydactyly, triangular phalanges causing finger deviation, and radial or ulnar hypoplasia causing forearm deviation. Early surgery is recommended in these cases to avoid further deformities that are more difficult to manage. Early is also generally defined as 6-8 months of age. 4, what kind of situation can wait until about one year old surgery If it is estimated that the development of the hand will not bring new, difficult to deal with deformity, you can wait a little longer, after all, the child grows older surgery will be safer, the operation is relatively easier. For example, central syndactyly (syndactyly, or syndactyly of the middle fingers), most of the time there is no obvious deviation of the fingers, but if there is a deviation, surgery should be performed as soon as possible. For example, in the case of polydactyly of the thumb, due to the need for complex osteotomies and muscle and tendon displacement operations, it is best to wait until the hand is large enough to operate. 5. Is it enough to do the surgery only once? No, most of the time it is not. After separation of syndactyly, skin grafting is required. The growth rate of the grafted area is slower than that of normal tissues, and it is possible that the webbing of the fingers may creep up after 5-6 years. This is when some of the more severe, or more demanding patients require another surgery. If the impact is minor, surgery may not be necessary. After thumb polydactyly, some patients may still experience joint instability, deviation, and poor mobility. At this point, another surgery is needed. Radial or ulnar dysplasia requires multiple complex corrective surgeries. Giant finger deformity requires surgery such as reduction, epiphyseal block, neurectomy transplantation, etc. according to the development of bones. Long-term regular review is needed. 6.Can the surgery achieve normal? This is what parents are most concerned about. Unfortunately, the answer is “never”. No matter how skillful the doctor is and how cooperative the patient is, the deformed or injured hand will always leave some after-effects in the end. The most successful surgeries are only close to normal, but never normal. Comparatively speaking, the best results are in simple syndactyly and polydactyly. Macrosomia is relatively difficult to treat, the satisfaction rate is not high, and a large proportion of the deformed fingers can only be amputated. 7. What can I expect from the surgery? I think there will be some improvement in function and appearance after the surgery. However, each person’s condition is different, and the surgical options are different, so it is difficult to predict the outcome accurately in advance. Sometimes, in severe deformities, such as multiple short finger deformities and missing finger deformities, we can only settle for the second best, improving function and enabling daily life, while the appearance is unsatisfactory. 8.Does the surgery require general anesthesia? General anesthesia is necessary. There is no information to prove that general anesthesia will affect intelligence.